Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Intralesional steroid infusion using a spray tube to prevent stenosis after endoscopic submucosal dissection of esophageal cancer

  • Atsushi Goto (Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine) ;
  • Takeshi Okamoto (Department of Gastroenterology and Hepatology, Yamaguchi Prefectural Grand Medical Center) ;
  • Ryo Ogawa (Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine) ;
  • Kouichi Hamabe (Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine) ;
  • Shinichi Hashimoto (Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine) ;
  • Jun Nishikawa (Faculty of Laboratory Science, Yamaguchi University Graduate School of Medicine) ;
  • Taro Takami (Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine)
  • Received : 2021.10.24
  • Accepted : 2021.12.23
  • Published : 2022.07.30
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Abstract

Background/Aims: Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopic submucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is used to directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluated its efficacy and safety. Methods: Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissection for superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence of stenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment. Results: Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosis in these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tube were observed. Conclusions: Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventing stenosis (clinical trial number, UMIN000037567).

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References

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